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• W2320900173 abstract "Introduction: We recently reported about an increased risk of abdominal complications in patients following lung transplantation (LuTx). These were associated with a high mortality in general and severe outcome especially following bowel perforation. We now questioned whether this phenomenon also can be found in patients after heart transplantation (HTx). Aim of the present study thus was to analyze the frequency and outcome of abdominal interventions following HTx and to compare these data to a re-evaluated pool of patients after LuTx to identify risk constellations with an impact on patient survival. Methods: Retrospective analysis of abdominal surgery conducted in 342 patients undergoing HTx and 1064 patients after LuTx at Hannover Medical School, Germany, between January 2000 and October 2011 was performed. Results: The incidence for abdominal surgery was comparable between patients following HTx (n=34; 9.9%) and LuTx (n=90; 8.5%). Elective operations were more frequently performed in patients after HTx than LuTx (8.8% vs. 5.2%), with a comparable interval between transplantation and intervention (51.5 ± 70.0 months vs. 49.9 ± 50.6 months, respectively). In contrast, the incidence of emergency interventions was higher after LuTx (5.3%) than following HTx (2.6%), whereby the interval between transplantation and emergency intervention was clearly shorter after LuTx (22.9 ± 37.6 months vs. 40.7 ± 65.8 months, respectively). Herewith associated was the mortality observed in patients with LuTx (18.9%) and HTx (8.8%). The leading diagnosis for emergency operations was bowel perforation (n=18, regarding all cases). In 11 of these patients perforation occurred within the first six months after transplantation and 6 of them died in the course of this complication (1 patient after HTx and 5 patients after LuTx). Conclusions: Abdominal complications after thoracic transplantation correlate with a high mortality rate. Perforation of the bowel was the leading diagnosis with a severe impact on the outcome, especially in the early phase after transplantation. At this specific time point of transplantation the patients are in need of a high immunosuppressive therapy to minimize the risk for rejection. In the influence of high doses of immunosuppression inflammatory responses likewise might be suppressed and clinical diagnostic of an acute abdomen subsequently made more difficult. We thus recommend in finding or even reasonable suspicion of an acute abdomen after thoracic transplantation a broad practice for extended diagnostics and a low barrier for an early explorative laparotomy." @default.
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• W2320900173 date "2012-11-01" @default.
• W2320900173 modified "2023-09-25" @default.
• W2320900173 title "The Impact of Abdominal Complications on the Outcome after Heart and Lung Transplantation - A Single Center Experience" @default.
• W2320900173 doi "https://doi.org/10.1097/00007890-201211271-00338" @default.
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